Our Embrace With Our Powerlessness Stabilizes More Than Our Power

In our growing familiarity with our fears about medication therapies, we are getting to know about control and identity.  Separate those in hopes that will help us bring them together later.

            I don’t want to lose control of my choices to the control of medication.

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Image by sillydog via Flickr

Jane had pocks on her face from childhood acne.  Kids had bullied her.  She learned to fight.  Jane’s mother had a boyfriend who victimized Jane.  She fought harder.  Not against her mom or her mother’s boyfriend, but against kids.  Jane left her mother’s home when she was fourteen and lived between friend’s houses.  Her story continued to develop.  Jane learned to really fight.  She bloodied herself to get control and she still had her teeth.

Jane had sold marijuana for five years when I saw her.  She had used one to two bowls a day since she was twelve.  It was one of the first things that had given her a sense of control.  Emotions sparking, nerves peeled back and exposed, dilated eyes, afraid and shaking; Marijuana took the peaks and filled in the valleys.

And what brought Jane in to my clinic?  This scraping, scratching survivor?  Weeping, Jane’s pocks folded as her face scrunched up.  Thirty-one years old and she was not in control.  Jane was suspicious of everyone who crossed her path, she couldn’t concentrate and just suffered an at fault motor-vehicle accident when she was ticketed for carrying marijuana.  Jane awaited her trial.

Reader, you see the push-me pull-me in the room.  Was Jane ever in control?  Are any of us?  Our embrace with our powerlessness stabilizes us more than our power.  This was the time in Jane’s life where she was available for help.  This was one of the best times of her life, even if she didn’t know it.  It is the surrender of all that we are, controlled and uncontrolled, to our Higher Power that stabilizes us.  Control comes from the outside in.

But being a friend to ourself isn’t about control.  It is about putting ourselves immediately and ultimately in the care of Love.   What does Love want for us?  To be good to ourselves.

We offer medication therapy (and sobriety) not to put us in control or to take away control.  Assuredly some of our goals will happen.  But still, we offer medication therapy when the benefits outweigh the risks to “Me.”  When it is friendly.  Not to erode us.  See blog-post, Self-Care Works You, Pushes You, Tires You Out Until You Are Happily Spent On Your Friend – You.

Over the past two days, we have asked a lot of questions and gotten insightful, perceptive, inspired and intuitive answers with power to connect us and point toward healing.  We will continue to explore these questions and these answers, as they will continue to influence our relationship with and ability to befriend “Me.”  For today, however, I will bank these Q & A pages and pause Jane’s story.  I send you into blog-post, Are Your Meds Safe?

 

Recipe for Treating Panic Disorder, According to Me

 

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Recipe for Treating Panic Disorder, According to Me:

1.  If it’s taking you to the emergency room feeling like you’re going to die, or your spouse can’t peel you off with your phone calls and new needs – you have a medical illness.  Get medication.

2.  If you are afraid of being humiliated by an episode so much that you avoid public places, or if you are more fearful than not – you have a medical illness.  Get medical treatment.

3.  If you are panicking out of the blue, without something setting you off/triggers like finding your husband in bed with your dentist – this is biological.  Get a medical physician’s opinion.

4.  If you are awakening from sleep in a panic attack, when you feel like you have to get out of bed and escape and the episode lasts for about 10+ minutes before you recover yourself – this is not because you’re not trying hard enough.  Get on a serotonerigic therapy and a sleep aid(s).

5.  If you are drinking more alcohol to relax and out of fear of going to bed – get suspicious and get smart.  Medication therapy or alcohol?  It stumps me when someone says they don’t feel comfortable with taking medication that has beed studied in double-blind studies on thousands of people and reviewed and analyzed and more… but they do feel comfortable with alcohol.  That’s not friendly with yourself.

6.  If you think you are going crazy and realize your fears and suspicions don’t make sense; if you think you are possibly going psychotic over and over – you’re having a medical illness of the brain and body called panic disorder.  Get to your nearest treating physician and trust them.

 

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7.  If this is you, don’t go get insight or supportive psychotherapy at least until you have been on medication therapy for 6-8 weeks.  What you are going through is not because your mom yells at you too much.  It doesn’t have to have a reason.  It is medical.  Treat it medically.  If you go to therapy too soon, you will see that you can’t give what you don’t have.  (I may have offended some people saying this.  Sorry.)

8.  If you don’t get treatment, expect that depression may likely follow soon.  Anxiety and depression are bedfellows and can’t be apart for long.

    Self-Care Tip #92 – View Panic as a medical illness.  It is.  Be a friend to yourself.

    Question:  Have you or someone you known used a similar recipe or a different one?  Please tell me your story.

    Are Your Meds Safe?

    A reader asked

    …once one starts a medicinal path, would the symptoms become worse than they were before the meds if the meds were stopped?

    There are many layers to this short question.

    1.  Just the act of stopping the medication may trigger a relapse.  Cold turkey’ing is only good for stories.

    Remember that relapsing in emotional illness threatens brain health.  For example, in depression, every time we relapse in the absence of the protective effects of medication (prophylaxis), we drop faster, we drop harder, and it is more difficult to treat.  It is more difficult to get a medication response.

    Furthermore, some medications that once were effective in treating disease, loose effect if they are stopped and restarted.  Significant in psychiatry as we don’t have innumerable options to treatment.  In one move, a medication was eliminated from our treatment choices and we have to move on to others.  We now try a different medication with possibly more side effects than the one we discontinued.

    Because of this, many people who have found effective treatment choose to stay on it as long as they can.

    2.  Some medications are not treating disease process so much as they are treating the symptoms of the disease.

    For example in anxiety, the class of medications called benzodiazepines (“benzos”) is often a favorite.  Common ones in this class include alprazolam, diazepam, clonazepam and lorazepam.  There are many more.

    Benzos take the symptoms of anxiety away quickly.  They are famously called “tranquilizers” and hit the GABA receptor, the same receptor as targeted by

    alcohol. Some people say that they are like taking alcohol in a pill.  They are not all bad or all good.  However, as pertains to my reader’s question above, the answer is yes.  The symptoms might be worse after stopping them than they were before using them.  If they have been used long enough for a tolerance to develop, and/or if they were being abused, much like alcohol might be abused, than yes.

    Remember, symptoms are what we see or feel.  The disease process itself is often unseen.

    Also, because this class of medications only treats the symptoms, we know that the disease process is likely still progressing.  Then when the medications are stopped, the symptoms show again.  However now that the disease is worse, so are the symptoms.  What the medications are doing in this example is called “masking the symptoms.”

    3.  There’s more I could cover but that’s enough for any of us tonight I am sure!

    Question:  Did any of this help?  Please tell me your story.

    Self Care tip #63 – Take your treatment in comfort, but know what you are taking and why.  Be a friend to yourself.

    Get Treatment to Move On – Addictions

    Molested by his cousin, neglected by his parents, he watched his intoxicated father beat his mother.  Thinking she would die too many times, he ran away, returned in a police car over and over again, as if wanting to get away was a crime.  He came back and raped his neighbor, more than once.  He spent a lot of time trying to get sex even though he knew it was ruining him and others.  He lost interest in almost everything else.  He suffered uncontrollable impulses.

    He was 18 years old when he left it all for the safety of prison.  During the next fifteen-some years he was diagnosed, treated, and kept.  But kept for what?  For eating.  He gained weight, until he needed 2 seats to sit in.  Eating became his preoccupation.  He didn’t have sex.  He had food.

    He was released to a home for sexual offenders, put on a diet and lost weight.  He lost it big and fast and felt in control.  He started purging and not finishing his meals.  He thought about purging all the time.  He knew he shouldn’t do it.  His voice was changing, raspy and his throat hurt but he still purged.  He wasn’t having sex.  He wasn’t over-eating.  He was purging.

    For whatever reason, no one had yet seen the pattern.  Mostly everyone saw sex offender.  Me included.  I was trying.  I was trying to treat him with empathy, trying to get past the bile that comes when I think of rape, trying to consider the courageous things this man was doing now in life.

    In one of my favorite scenes from the film, Rachel Getting Married, Kim played by Anne Hathaway argues with her sister about her own chances to have a future:

    Rachel: Kym, you took Ethan for granted. Okay? You were high for his life. You were not present. Okay? You were high.
    Kym: [Whispering] Yes.
    Rachel: And you drove him off a bridge… and now he’s dead….
    Kym: Yes, I was. Yes, I was stoned out of my mind. Who do I have to be now? I mean, I could be Mother Teresa and it wouldn’t make a difference, what I did. Did I sacrifice every bit of… love I’m allowed for this life because I killed our little brother?

    I thought of this and somehow through all that trying, I did. And because I could empathize, a space opened up for me to be more objective.  That’s when I saw it.  I saw the pattern.

    Addictions migrate.  Someone who may have started out as a food addict, might turn to gambling, and then later to alcohol.  Someone with sex addiction, might turn to food and then later to purging.

    It can be like that game I used to play at Chucky Cheese, trying to hammer down the little animals that pop out of holes.  We need to treat the disease of Addiction regardless of how it’s dressed, or else it will keep popping up.  And like Kym, if we do, although perhaps terribly wrong in some unchangeable ways, we will still have a future.  If you’d like to read more about this “kainos” (Greek word for the opportunity to be made new,) read the post New versus New.

    Self Care Tip #62 – Get treatment to move on.  Be a friend to yourself.

    Question:  What do you think?  Please tell me your story.

    A Little Bit is Not Enough – Claim Full Health

    The good news is, I just ate 3 chocolate chip cookies.  You already know the bad news.  Has nothing to do with my post.  I’m just sharing it for the sake of your own

    Schadenfreude 🙂

    …Onward.  Question:

    Does emotional disease get worse even while on medication therapy?  Sometimes.  It does so more often when the disease process is treated but only partially treated.  Read a little more about this in this post if your interested.  A primary care physician recently told me, “I think the term ‘Partial Responder’ is a marketing gimmick to get physicians to prescribe more medications.  I don’t think it even exists.”

    There’s a lot to be said about interview skills in sussing out the partial responder.  If I asked someone if they felt better, many things play into their response. Everyone’s responses are biased of course.  We don’t have sterile minds.  For example there’s the patient who wants to please their physician.  “Yes I’m better!”  i.e. “Yes you’re a good doctor!”  There are the patients who don’t want to be patients and minimize whatever they’re going through.  There is the physician who leads the interview.  “So, you’re feeling better?”  “The medication is helping?”

    Partial response means that at the end of a full treatment initiation period, there is some disease remaining but a reduction of disease.  For example, in depression, I may no longer be suicidal, but I still have trouble feeling pleasure in life.  In cancer it means that there is tumor reduction of at least 30%.

    Now why would a physician presumably agree that there is a partial response in cancer, but not agree that it happens in mental health?  Anyways….  (Ahem.)  When we partly respond to mental health treatment and don’t push further for full response, about 70% will relapse.  Versus maybe 25% in those who reached their pre-disease baseline emotional health through treatment.

    Don’t get lost in this.  The point is, get treated and get fully treated.  Mental illness is progressive and causes changes at the cell level.  The brain is connected to the rest of our body.  The brain is human.  A bit better, is not enough.

    Self Care Tip #61 – Go all the way!  Claim health.  Be a friend to yourself.

    Question:  Did you find this to be true in yourself or someone you know?  Please tell me your story.

    This Side of the Fence

    When taking care of ourselves, we are taking care of others.  It might be counterintuitive.  There is a circle service can turn us in.  I give to you, I take care of you, I start realizing at some level that I’m not being taken care of, I hold you responsible now for my neglect, and then around again.  Some support this pattern from cultural influences.  Some with intuition.

    This can be a place we find ourselves in our relationship to anything or anyone.  Employment or even unemployment.  We may find ourselves saying things like why me, or feeling like we are selected out by some greater force to suffer.  Any time self-reflection whispers anything about the word “victim,” look for the “circle-walk.”

    Now some listening to this might say service is the best thing of their lives and imply that without service, life isn’t right.  Sure.  However, that’s not my argument.  Mine is that taking care of one’s own self is also a form of service to others.  In fact, let’s boldly put taking care of one’s self at the top of the service list.  Standing up there can feel awkward, presumptive, selfish, unChristian.  What does it feel like for you?

    I’m told 😉 this is hard.  It is.  We just try our best.  Every day we try again.  Every moment we remember, we try.  My husband often says, “God is a God of second chances.”  I think He wants us to treat ourselves with as much courtesy.

    In addictions therapy, we tell the addict that a relapse isn’t a failure, it is part of the road to recovery.  When we take care of ourselves, we may find ourselves up against any number of forces, including patterned negative behaviors. We can learn from the brave people fighting the disease of addiction. When we don’t treat ourselves well, we are not a failure.  Rather we are on the road to becoming a better friend to ourselves.  That also takes courage.

    Onward and upward my friends!  Let me know what you think.

    Self Care Tip #28 – Look at your own side of the fence.  Be a friend to yourself.